Evidence map›Paper›PMID 38036867›Full record

ReviewSpine deformity2024

Inflation-adjusted medicare physician reimbursement for adult spinal deformity surgery substantially declined from 2002 to 2020.

Kevin C Mo, Carlos Ortiz-Babilonia, Farah N Musharbash, Micheal Raad, Juan Silva Aponte, Brian J Neuman, Amit Jain, Khaled M Kebaish

Abstract readReview
PubMed Publisher
In one paragraph

Review in Spine deformity, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kevin C MoDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA.ORCID 0000-0002-7728-0093
Carlos Ortiz-BabiloniaDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA.ORCID 0000-0003-0722-6937
Farah N MusharbashDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA.ORCID 0000-0003-0739-2863
Micheal RaadDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA.ORCID 0000-0001-8167-5808
Juan Silva AponteDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA.ORCID 0000-0003-3240-0589
Brian J NeumanDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA.ORCID 0000-0001-9467-613X
Amit JainDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA.ORCID 0000-0002-9983-3365
Khaled M KebaishDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, JHOC 5223, Baltimore, MD, 21287, USA. kkebais@jhmi.edu.ORCID 0000-0002-1235-6202

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePhysician fees for orthopaedic surgeons by the Centers for Medicare and Medicaid Services (CMS) are increasingly scrutinized. The present retrospective review aims to assess whether adult spinal deformity (ASD) surgeries are properly valued for Medicare reimbursement.

methodsCurrent Procedural Terminology (CPT) codes related to posterior fusion of spinal deformity of ≤ 6, 7-12, and ≥ 13 vertebral levels, as well as additional arthrodesis and osteotomy levels, were assessed for (1) Compound annual growth rate (CAGR) from 2002 to 2020, calculated using physician fee data from the CMS Physician Fee Schedule Look-Up Tool; and (2) work relative value units (RVUs) per operative minute, using data from the National Surgical Quality Improvement Program.

resultsFrom 2002 to 2020, all CPT codes for ASD surgery had negative inflation-adjusted CAGRs (range, - 18.49% to - 27.66%). Mean physician fees for spinal fusion declined by 26.02% (CAGR, - 1.66%) in ≤ 6-level fusion, 27.91% (CAGR, - 1.80%) in 7- to 12-level fusion, and 28.25% (CAGR, - 1.83%) ≥ 13-level fusion. Fees for both 7-12 (P < 0.00001) and ≥ 13 levels (P < 0.00001) declined more than those for fusion of ≤ 6 vertebral levels. RVU per minute was lower for 7- to 12-level and ≥ 13-level (P < 0.00001 for both) ASD surgeries than for ≤ 6-level.

conclusionsReimbursement for ASD surgery declined overall. CAGR for fusions of ≥ 7 levels were lower than those for fusions of ≤ 6 levels. For 2012-2018, ≥ 7-level fusions had lower RVU per minute than ≤ 6-level fusions. Revaluation of Medicare reimbursement for longer-level ASD surgeries may be warranted. LEVEL OF EVIDENCE: III.

Indexed as

PhysiciansSpinal FusionAdultAgedHumansMedicareNeurosurgical ProceduresQuality ImprovementUnited StatesAdult spinal deformityASDCPTInflationMedicareRVU

Identifiers

PMID38036867

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.